Sediment and Erosion Control Permit
Holmes County Soil & Conservation District
62 West Clinton Street; Millersburg, Ohio 44654
Phone: (330) 674-2811
 
____________________________                _________________________________
Applicant Name                                                    Subdivision Name
 
Location of Proposed Earth Disturbing Activity (address)
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Please describe the proposed earth-disturbing activity and total area to be disturbed during construction.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
 
Approximate Date:_____________________________
 
I agree to develop and construct on this lot in a manner which will minimize erosion and sedimentation.  At a minimum, all disturbed areas on the lot described above shall be stabilized if they are at final grade or will not be regraded or disturbed further for a period of 30 days or more.  Soil stabilization shall be applied within seven (7) days from being last disturbed.  Sediment barriers, settling ponds, or other control structures shall be used as recommended by the Holmes Soil and Water Conservation District.
 
I hereby certify that I understand the provisions of the Holmes County Subdivision Regulations Sections 9.04 and 9.05 and that I accept responsibility for containing sediment and erosion on the construction site during construction activities.  I further grant the right-of-entry onto the project site of the designated personnel of the Holmes Soil and Water Conservation District for the purpose of inspecting for compliance with the Holmes County Subdivision Regulations Sections 9.04 and 9.05.  Neither the District or its representatives, nor the land owner will be liable for any damage to the other's property in carrying out the provisions of the agreement, unless such damage is caused by negligence or misconduct.
 
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Signature of Landowner or Person Responsible for Construction Site                            Date
 
______________________________________________________________________
Address
 
______________________________________________________________________
Phone
 
Fee: $10.00  Payable to Holmes SWCD
 
______________________________________________________________________
Received By                                                                                                                             Date
 
A copy Holmes County Subdivision Regulations Sections 9.04-9.05 and a copy of Rainwater and Land Development are available at Holmes County Soil and Water Conservation District.
 
THIS PERMIT MUST BE RETAINED ON-SITE AT ALL TIMES DURING CONSTRUCTION ACTIVITY.
 
Please return a copy of this permit to the Holmes County Soil & Water Conservation District.
 

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